The impact of healthcare insurance on the utilisation of facility-based delivery for childbirth in the Philippines

Gouda, Hebe N, Hodge, Andrew, Bermejo R 3rd,, Zeck W, and Jimenez-Soto E. (2016) The impact of healthcare insurance on the utilisation of facility-based delivery for childbirth in the Philippines. PloS One, 11 12: e0167268. doi:10.1371/journal.pone.0167268

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Author Gouda, Hebe N
Hodge, Andrew
Bermejo R 3rd,
Zeck W,
Jimenez-Soto E.
Title The impact of healthcare insurance on the utilisation of facility-based delivery for childbirth in the Philippines
Journal name PloS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2016-12-02
Year available 2016
Sub-type Article (original research)
DOI 10.1371/journal.pone.0167268
Open Access Status DOI
Volume 11
Issue 12
Start page e0167268
Total pages 15
Place of publication San Francisco, United States
Publisher Public Library of Science
Language eng
Subject 2700 Medicine
1300 Biochemistry, Genetics and Molecular Biology
1100 Agricultural and Biological Sciences
Abstract Objectives In recent years, the government of the Philippines embarked upon an ambitious Universal Health Care program, underpinned by the rapid scale-up of subsidized insurance coverage for poor and vulnerable populations. With a view of reducing the stubbornly high maternal mortality rates in the country, the program has a strong focus on maternal health services and is supported by a national policy of universal facility-based delivery (FBD). In this study, we examine the impact that recent reforms expanding health insurance coverage have had on FBD. Results Data from the most recent Philippines 2013 Demographic Health Survey was employed. This study applies quasi-experimental methods using propensity scores along with alternative matching techniques and weighted regression to control for self-selection and investigate the impact of health insurance on the utilization of FBD. Findings Our findings reveal that the likelihood of FBD for women who are insured is between 5 to 10 percent higher than for those without insurance. The impact of health insurance is more pronounced amongst rural and poor women for whom insurance leads to a 9 to 11 per cent higher likelihood of FBD. Conclusions We conclude that increasing health insurance coverage is likely to be an effective approach to increase women's access to FBD. Our findings suggest that when such coverage is subsidized, as it is the case in the Philippines, women from poor and rural populations are likely to benefit the most.
Formatted abstract
Objectives
In recent years, the government of the Philippines embarked upon an ambitious Universal Health Care program, underpinned by the rapid scale-up of subsidized insurance coverage for poor and vulnerable populations. With a view of reducing the stubbornly high maternal mortality rates in the country, the program has a strong focus on maternal health services and is supported by a national policy of universal facility-based delivery (FBD). In this study, we examine the impact that recent reforms expanding health insurance coverage have had on FBD.

Results
Data from the most recent Philippines 2013 Demographic Health Survey was employed. This study applies quasi-experimental methods using propensity scores along with alternative matching techniques and weighted regression to control for self-selection and investigate the impact of health insurance on the utilization of FBD.

Findings
Our findings reveal that the likelihood of FBD for women who are insured is between 5 to 10 percent higher than for those without insurance. The impact of health insurance is more pronounced amongst rural and poor women for whom insurance leads to a 9 to 11 per cent higher likelihood of FBD.

Conclusions
We conclude that increasing health insurance coverage is likely to be an effective approach to increase women’s access to FBD. Our findings suggest that when such coverage is subsidized, as it is the case in the Philippines, women from poor and rural populations are likely to benefit the most.
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Document type: Journal Article
Sub-type: Article (original research)
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Created: Tue, 06 Dec 2016, 08:38:15 EST by Hebe Gouda on behalf of School of Public Health